Introduction to Chest

Imaging
Imaging Techniques of the Chest

• Plain radiography: routine, special.

• Fluoroscopy with and without contrast.
• Tomography.
• C.T scanning
• MRI.
• Scintigraphy=Isotope studies.
• Bronchography.
• Pulmonary Angiography and bronchial
Arteriography.
• Ultrasound.
Plain Radiography of The Chest

• Importance of Chest X-ray :

– Diagnosis & follow up of chest & heart
diseases.
– Routine pre-employment examination.
– Routine preoperative examination
– Follow up of malignancy
– Medical checkup.
Plain Radiography of The Chest

• Routine Chest X-ray : PA View (Movie clip)

Normal PA View of the chest
Plain Radiography of The Chest

• Chest X-ray : Lateral View (Movie clip)

Normal Lateral View of the chest
Plain Radiography of The Chest
• CRITERIA OF A GOOD X-RAY OF THE CHEST
• Patient central
– a-Sterno-clavincular junction equidistant from midline
(spinous process).
– b-Mediasternum 2/3 to left and 1/3 to right
• See diaphragm low down i.e. inspiratory film.
• Intervertebral disc spaces and anterior end of ribs
not seen through cardiac shadow and if seen it
means an over exposed film.
• Costo-phrenic and cardio-phrenic are seen
• Lung apices appear and lower 3 cervical vertebrae.
• Scapula away from lung field.
Centrally Positioned Film

Rotated Film
 Penetration (Exposure)

Under Exposed (Soft) Over Exposed (hard)

 Respiration

Expiration Inspiration
Plain Radiography of The Chest

• Radiological Anatomy of The chest

Normal PA View of the chest
Bronchopulmonary segmentation
Case Presentation
RUL Atelectasis (Collapse)
RML Atelectasis (Collapse)
RML Pneumonia (consolidation)
Lung Abscess
TB
TB
COPD (Chronic Bronchitis)
COPD (Emphysema)
Cystic Bronchiectasis
Bilateral Bullae
Central Bronchogenic Carcinoma
Central Bronchogenic Carcinoma (CT)
Peripheral Bronchogenic Carcinoma (DD Solitary Pulmonary Nodule)
Metastasis
Calcified Cannon Ball Metastasis
IPF
Pleural Effusion
Pleural Effusion
Pleural Effusion
Pleural Effusion + Fracture Ribs
Right Pneumothorax
Pneumothorax
Left Tension Pneumothorax
Right Pneumothorax CT
Right Hydropneumothorax
Foreign Body of the Airways